- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,128.61 / $43,651.58
| Facility | | $3,388.44 | $5,128.61 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,258.93 / $1,548.82
| Professional | | $630.96 | $1,258.93 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $40,738.03 / $50,118.72
| Facility | | $28,183.83 | $40,738.03 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $4.57
| Professional | | $3.02 | $3.98 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $31,622.78 / $47,863.01
| Facility | | $13,803.84 | $31,622.78 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,168.69 / $48,977.88
| Facility | | $1,288.25 | $4,168.69 | $48,977.88 |